Post on 25-Nov-2015
description
transcript
PROPER POSTURES TherapyProtocols
PROPERPOSTURESSagar Naik, PT, Dr. Saravanan, Dr. Prerana, Dr. Bhargav Desai
SITTING
NEVERALLOWSLOUCHPOSTUREWHILESITTING
ENCOURAGETOUSELUMBARROLLTOMAINTAINLUMBARLORDOSIS
ADVICEFIRMSTRAIGHTBACKCHAIRS
Thera
pyProto
cols
PROPER POSTURES TherapyProtocols
AVOIDBACKLESSCHAIR(REQUIREDTHENUSENADACHAIR)
ENCOURAGE FREQUENT MOVEMENT BREAKS. INSTRUCT PATIENT TOAVOID SITTING LONGER THAN20MINUTESATA TIME FOR THE FIRST2WEEKSANDTHENGRADUALLY INCREASEDEPENDINGONTOLERANCETOPAINALLOW PATIENT TO RETURN TO DRIVING FOR SHORT PERIODS AFTERABOUT1TO2WEEKS.REMINDTHEPATIENTTHATSAFETY ISAPRIORITYFROMTHEMNOTACONVENIENCE.
STANDING&WALKING
1) ADVICE PATIENTS TO LIMIT STANDINGAT THE KITCHEN SINKOR BATHROOMCOUNTERTOSHORTPERIODS.
2) AVOIDBENDINGATTHEWAIST.3) ENCOURAGE PATIENT TO MAINTAIN LUMBAR LORDOSIS DURING STANDING
ANDWALKINGWHILEPERFORMINGABDOMINALBRACE.
Thera
pyProto
cols
PROPER POSTURES TherapyProtocols
SLEEPING
LYINGONSOFTMATRESSESORSOFAS
Thera
pyProto
cols
PROPER POSTURES TherapyProtocols
BODYMECHANICS
TRANSFERS
1) TEACHPATIENTTOMOVECORRECTLYFROMSUPINETOSITTING
Thera
pyProto
cols
PROPER POSTURES TherapyProtocols
2) TEACH PATIENT TO MOVE CORRECTLY FROM STANDING TO LYING ON THEFLOOR
Thera
pyProto
cols
PROPER POSTURES TherapyProtocols
3) TEACHPATIENTTOMOVECORRECTLYFROMSITTINGTOSTANDING
4) ROLLING IN BEDASAUNITAND RISING FROM BED SHOULD BE PERFORMEDCORRECTLY.
5) ALLTWISTINGMOVEMENTS SHOULDBEAVOIDED. INSTRUCTTOMOVETHEIRFEETTOTURNINSTEAD.
Thera
pyProto
cols
PROPER POSTURES TherapyProtocols
DRESSING
1) INSTRUCTTHEPATIENT INTHECORRECTWAYTOPUTONPANTS,SOCKS,ANDSHOESINTHESUPINEPOSITION.
2) SLIPONSHOESARETHEEASIESTTOHANDLEINTHEFIRST2WEEKS.3) TYINGSHOESCANLATERBEPERFORMEDSAFELYBYPUTTINGTHEFOOTONA
STOOLORCHAIR.
HYGIENE
1) SHOWERINGCANBEGINAFTERTHESECONDWEEK.2) PATIENTCANSHOWERLEGS INSTANDINGPOSITION,WITHFOOTONTHETUB
ORSHOWERSEAT,AVOIDINGLUMBARFLEXION.
Thera
pyProto
cols
PROPER POSTURES TherapyProtocols
LIFTING
1) AVOIDALLLIFTINGINPHASEI.2) SWOOP LIFTING IS USUALLY A SAFE AND WELLTOLERATED TECHNIQUE FOR
LIFTINGINPHASEII.It isperformedbymakinga long stride forward to thekneelingposition (lunge)andthenreachingtoliftalightobject.
Thera
pyProto
cols
PROPER POSTURES TherapyProtocols
BENDING
1) AVOIDALLBENDINGMOVEMENTSATWAIST.2) LUMBARFLEXIONWITHLOADINGISTHEMOSTHAZARDOUSMOVEMENTINTHE
FIRST2PHASES.3) OCCASIONALLYLIMITEDBENDINGISNECESSARY.
Patientcansafelybendbysimultaneouslyflexingatthekneesandhips(HINGEATTHEHIPS)whilemaintaininganeutralspineandanabdominalbrace.
Thera
pyProto
cols
PROPER POSTURES TherapyProtocols
KINESTHETICPROPRIOCEPTIVECOORDINATION
1) Patients with low back pain may possess poor kinestheticproprioceptivecoordination.
2) Thiscanbeimprovedbyusinglumbartape.3) Therapist places the patient on all fours and asks to maintain neutral spine
position.4) Thentherapistplacesa12to18cmlongtapeontheparaspinalsparalleltothe
spine,avoidingincisionsite.5) Then patient is asked to make small movements into flexion and extension,
alwaysreturningtoneutral.6) Additional feedback from tape puling or wrinkling will assist the patient in
learningspinalproprioception.7) Various postures can be tried, including kneeling, sidelying, sitting, standing,
withsmallmotionsofthelumbarspine.8) Patientcanprogresstofunctionalmovementslikewalking,transfers.
Thera
pyProto
cols
PROPER POSTURES TherapyProtocols
Thera
pyProto
cols